First Patient Enrolled In European Deep Brain Stimulation Registry For Refractory Epilepsy

In short

Medtronic, Inc. has announced the first patient enrolment into the MORE (MedtrOnic Registry for Epilepsy) Registry, which is designed to look at the long-term efficacy, quality of life impact and safety of deep brain stimulation (DBS) in patients with refractory epilepsy.

Background

The commencement of the MORE Registry comes as the neuromodulation community celebrates 25 years of DBS therapy, Professors Benabid and Pollak having performed the first DBS implant for Essential Tremor at the University of Grenoble in January 1986.

Refractory or drug resistant epilepsy is defined by the International League Against Epilepsy (ILAE) as: “the failure of adequate trials of two tolerated and appropriately chosen and used AED (anti-epileptic drugs) schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom”. Approximately 30% of epilepsy patients suffer from the refractory form.

Currently, Medtronic DBS therapy is approved for use as adjunctive therapy for reducing the frequency of seizures in adults diagnosed with epilepsy characterized by partial-onset seizures, with or without secondary generalization, that are refractory to antiepileptic medications.

In Europe, Medtronic DBS Therapy has been CE mark approved for the treatment of tremor since 1993, Parkinson’s disease since 1998 and primary dystonia since 2003. The first approved implant of Medtronic DBS was carried out in 1993. More recently, Medtronic DBS therapy has received CE mark approval for obsessive compulsive disorder (OCD) in July 2009 and most recently for refractory epilepsy in August 2010.

The MORE Registry

The MORE Registry will involve approximately 200 prospective patients over two years from more than 30 centres across Europe including the Tampere and Tubingen Hospitals which have the most experience to date with DBS of the Anterior Nucleus of the Thalamus. The primary objective of the registry is to examine the impact of DBS therapy on seizure frequency. The study will also look at seizure type and severity, safety and impact of the therapy on a patient’s quality of life.

The MORE registry is the latest in a long history of research using Medtronic DBS devices including three Level 1 studies of DBS for Parkinson’s disease, one Level 1 study of DBS for Epilepsy and a 10- year follow up study of DBS in Parkinson’s disease led by the University of Toronto.

Clinician comments

“The MORE registry is important in increasing our understanding of how electrical stimulation can help patients affected by refractory epilepsy. By studying the long-term impact of DBS on the anterior nucleus of the thalamus, we hope to understand even further how seizures can be controlled and reduced,” said Professor Paul Boon, Professor of Neurology at the Department of Neurology, Ghent University Hospital in Belgium who is the chair of the steering group behind the MORE Registry.

“It is amazing to think how far we have come since the first experimental implant of deep brain stimulation for a movement disorder in the 1980s to today where the therapy is now approved for conditions such as epilepsy and treatment-resistant obsessive-compulsive disorder (OCD),” said Professor Pierre Pollak, Head of Neurology at the University Hospital Geneva.

Company comments

“Working with leading physicians, Medtronic helped pioneer deep brain stimulation, and we continue to collaborate with leading researchers to advance DBS technology and research next-generation therapies to treat chronic neurological conditions,” said Lothar Krinke, Ph.D., vice president and general manager for the Deep Brain Stimulation business in Medtronic’s Neuromodulation division.

Note: Medtronic DBS Therapy is not currently approved by the U.S. Food and Drug Administration for use in the United States for the treatment of refractory epilepsy.